1821091687 NPI number — DR. MICHAEL G MORONT MD

Table of content: DR. ROBIN H FIERSTEIN PSY.D. (NPI 1083117717)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821091687 NPI number — DR. MICHAEL G MORONT MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORONT
Provider First Name:
MICHAEL
Provider Middle Name:
G
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821091687
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/03/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2109 HUGHES DR
Provider Second Line Business Mailing Address:
STE 720
Provider Business Mailing Address City Name:
TOLEDO
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43606-5110
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-291-2077
Provider Business Mailing Address Fax Number:
419-291-2122

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2109 HUGHES DR
Provider Second Line Business Practice Location Address:
STE 720
Provider Business Practice Location Address City Name:
TOLEDO
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43606-5110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-291-2077
Provider Business Practice Location Address Fax Number:
419-291-2122
Provider Enumeration Date:
05/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208G00000X , with the licence number:  35064753M , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P00771509 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 433252 . This is a "AETNA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000284205 . This is a "UNISON AGED BLIND & DISABLED" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 03821 . This is a "PARAMOUNT" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000635454 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0921444 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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